Connecticut advocates criticized a proposal by Gov. Ned Lamont to end the Community First Choice home care program, saying the change would reduce autonomy and increase the likelihood of long waits for people who rely on home-based services.
The program, which provides funds through Medicaid, allows eligible people to use attendants of their choosing to help with daily living tasks. Lamont’s plan would transition people to Medicaid “waiver” programs, which the proposal says are less flexible and often have long waiting lists.
In fiscal year 2025, Connecticut spent more than $4.3 billion on long-term care, accounting for almost 40% of the state’s entire Medicaid budget, according to the reporting. Roughly 60% of that spending went toward home- and community-based care, while the rest went toward institutional care.
A central difference raised by supporters and critics is how enrollment works. Unlike waiver programs, which cap participation and can leave people waiting years, Community First Choice enrollment has never been capped, and anyone who qualifies can sign up.
Advocates said families are worried about losing a program they see as working and keeping people out of institutions. Lorra Jorden, whose family uses the program for at-home care for her son, said, “For the governor to even propose cutting this program is just unbelievably cruel,” and urged lawmakers to reject the plan. She also said, “It has been a wonderful, successful, program to keep people like my son at home, safe and sound.”
Lamont administration officials have defended the proposal as a response to rising costs and capacity limits. Chris Collibee, a spokesperson for the governor’s budget office, said the state has “years-long waitlists on our waiver programs” and that the goal is to reinvest some Community First Choice savings into the waivers so that people are not on waitlists for years.
The reporting also said officials agree that community-based care—which includes Community First Choice and waiver programs—is more cost effective than institutional care in most cases, but that Community First Choice enrollment and costs have “exploded” and are diverting resources from other home- and community-based programs. Between 2018 and 2025, enrollment more than doubled, and program costs rose from $88.8 million to $371 million a year.
In testimony at the legislature last month, Department of Social Services Commissioner Andrea Barton Reeves called the level of enrollment “unsustainable,” according to the reporting. Rob Blanchard, a spokesperson for the governor, also said the administration is concerned about what he described as the burdens placed on participants, including recruiting and managing caregivers. Blanchard said the governor’s proposal would replace parts of that structure with agency-based services and would still offer people who hire their own personal care attendants enhanced support and case management.
Advocates and disability-rights officials argued that shifting new enrollment to waiver programs would recreate or worsen waitlists and undermine the ability to get home care. Sheldon Toubman, an attorney with Disability Rights Connecticut, called the governor’s assertion “bogus” and said agency-based services could be offered alongside Community First Choice rather than eliminating it. He also said waiver programs can have waiting lists some as long as 10 years and asked lawmakers, “Even if we came up with the money for these people, what about the people already waiting on the waiting list for years?”
Other critics echoed that argument, including Mary-Ann Langton, who has participated in Community First Choice since 2015 and said, “I don’t belong in a nursing home. I belong in the community.” Tom Fiorentino, head of the Department of Social Services subcommittee that advises on the program, said eliminating Community First Choice would be like removing an oxygen tube without addressing the immediate need, and he said, “That’s not how you run programs.”